Credentialing Coordinator

New Provider Credentialing

Serve as the primary point of contact for internal credentialing for new providers.
Monitor provider progress through the MindCare Internal Credentialing process and follow up on incomplete, missing, unclear, or expired items.
Communicate clearly with providers.
Support timely resolution of rate-limiting steps that could delay internal credentialing, facility credentialing, scheduling, deployment, or provider start dates.
Create or confirm the credentialing/licensing ticket is opened, ownership is assigned, and provider application access and instructions are sent through the credentialing application.

Credentialing

Maintain accurate documentation of provider status, outstanding requirements, facility-specific needs, and deployment readiness.
Review credentialing application status for completeness, identify missing items, and ensure follow-ups are sent to providers or internal owners.
Maintain real-time status tracking of provider and facility applications, including outstanding items, credentialing progress, licensing readiness, and facility-specific requirements.
Ensure provider documentation is evaluated against facility requirements and applicable regulatory and compliance standards.
Perform or coordinate primary source verification of licensure and board certification, and flag discrepancies, history gaps, expired items, or missing elements.
Manage hospital/facility credentialing applications and enter, validate, or update affiliation data, including start/end dates and current versus prior affiliations.
Add or update facility records when missing and communicate with providers to obtain information needed for facility credentialing or affiliation records.
Track provider state licenses, DEA/CDS registrations, facility privileges, and related expirables to support deployment readiness and compliance timelines.
Initiate new license applications, renewals, and reappointment/recredentialing processes; coordinate with state boards, providers, and internal stakeholders as needed.
Identify additional insurance coverage needs, including state-specific requirements, and coordinate next steps with the appropriate owner.
Process provider enrollment applications for government and commercial insurance networks to secure in-network status.

Cross Functional Collaboration

Work closely with HR, Recruiting, Credentialing, Scheduling, Clinical Optimization, Partner Success, Revenue Cycle, and partner account stakeholders.
Escalate workflow delays, incomplete provider action items, partner-specific blockers, scheduling concerns, or credentialing risks to the appropriate internal teams.
Promote consistent communication between internal departments so providers move efficiently from new hire status to active deployment.
Receive, track, and follow up on OPPE/FPPE requests in partnership with Care Navigation and Clinical teams.